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Fluid management, electrolytes imbalance and renal management in neonates with neonatal encephalopathy treated with hypothermia
Kidney dysfunction and acute kidney injury (AKI) frequently accompanies neonatal encephalopathy and contributes to neonatal morbidity and mortality. While there are currently no proven therapies for the treatment of AKI, understanding the pathophysiology along with early recognition and treatment of alterations in fluid, electrolyte and metabolic homeostasis that accompany AKI offer opportunity to reduce associated morbidity. Promising new tests and technologies, including urine and serum biomarkers and renal near-infrared spectroscopy offer opportunities to improve diagnosis and monitoring of neonates at risk for kidney i...
Source: Seminars in Fetal and Neonatal Medicine - June 11, 2021 Category: Perinatology & Neonatology Authors: Jeffrey L. Segar, Valerie Y-L. Chock, Matthew W. Harer, David T. Selewski, David J. Askenazi, Newborn Brain Society Guidelines and Publications Committee Source Type: research

Editorial Board
(Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 27, 2021 Category: Perinatology & Neonatology Source Type: research

Translational insights into mechanisms and preventive strategies after renal injury in neonates
Adverse perinatal circumstances can cause acute kidney injury (AKI) and contribute to chronic kidney disease (CKD). Accumulating evidence indicate that a wide spectrum of perinatal conditions interferes with normal kidney development and ultimately leads to aberrant kidney structure and function later in life. The present review addresses the lack of mechanistic knowledge with regard to perinatal origins of CKD and provides a comprehensive overview of pre- and peri-natal insults, including genetic predisposition, suboptimal nutritional supply, obesity and maternal metabolic disorders, placental insufficiency leading to int...
Source: Seminars in Fetal and Neonatal Medicine - May 7, 2021 Category: Perinatology & Neonatology Authors: Jenny Voggel, Jasmine Mohr, Kai D. N üsken, Jörg Dötsch, Eva Nüsken, Miguel A. Alejandre Alcazar Source Type: research

Cooling in mild encephalopathy: Costs and perils of therapeutic creep
Increasing confidence in therapeutic hypothermia and ambiguity of cooling guidelines has led to many clinicians extending its use to untested populations like mild encephalopathy, or even no encephalopathy. Poor quality clinical neurological examination for encephalopathy staging coupled with a fear of litigation if a baby with mild encephalopathy progress to moderate or severe encephalopathy appears to be the primary driver for this therapeutic creep. Recent data suggesting increased apoptosis with cooling uninjured brains, and lack of hypothermic neuroprotection in partial prolonged hypoxia, implies that such therapeutic...
Source: Seminars in Fetal and Neonatal Medicine - April 8, 2021 Category: Perinatology & Neonatology Authors: Vijay Kumar, Mani Singla, Sudhin Thayyil Source Type: research

Editorial Board
(Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 1, 2021 Category: Perinatology & Neonatology Source Type: research

Insights into the mechanisms of alveolarization - Implications for lung regeneration and cell therapies
Although the lung has extensive regenerative capacity, some diseases affecting the distal lung result in irreversible loss of pulmonary alveoli. Hitherto, treatments are supportive and do not specifically target tissue repair. Regenerative medicine offers prospects to promote lung repair and regeneration. The neonatal lung may be particularly receptive, because of its growth potential, compared to the adult lung. Based on our current understanding of neonatal lung injury, the ideal therapeutic approach includes mitigation of inflammation and fibrosis, and induction of regenerative signals. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - March 29, 2021 Category: Perinatology & Neonatology Authors: Maria Hurskainen, Chan èle Cyr-Depauw, Bernard Thébaud Source Type: research

Newborn resuscitation devices: The known unknowns and the unknown unknowns
Infant resuscitation devices used at birth must be capable of delivering adequate and consistent ventilation in a controlled and predictable manner to a wide patient weight range, and combinations of transitional lung states. Manual inflation resuscitation devices delivering positive pressure lung inflation at birth can be classified broadly into two types: 1) flow generating, ie silicone self-inflating bags (SIB) also known as bag valve mask (BVM) and 2) flow dependent, ie anaesthetic flow inflating bag (FIB) and t-piece resuscitator (TPR) systems (eg: Neopuff, GE Panda and Draeger Resuscitaires). (Source: Seminars in Fet...
Source: Seminars in Fetal and Neonatal Medicine - March 19, 2021 Category: Perinatology & Neonatology Authors: Murray Hinder, Mark Tracy Source Type: research

LISA/MIST: complex clinical problems almost never have easy solutions
Over the last 10 years, new techniques to administer surfactant have been promoted, based on their presumed lesser invasiveness and they have been generally called LISA (less invasive surfactant administration). We believe that the clinical potential of LISA techniques is currently overestimated. LISA lacks biological and pathophysiological background justifying its potential benefits. Moreover, LISA has been investigated in clinical trials without previous translational data and these trials are affected by significant flaws. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - March 18, 2021 Category: Perinatology & Neonatology Authors: Daniele De Luca, Shivani Shankar-Aguilera, Eduardo Bancalari Source Type: research

Chapter for Antenatal Steroids – treatment drift for a potent therapy with unknown long-term safety Seminars in Fetal and Neonatal Medicine
This chapter on therapeutic drift with antenatal steroids will make the case that this pilar of treatment to improve the outcomes of preterm infants, despite multiple Randomized Control Trials (RCTs) and meta-analysis, has multiple gaps in solid clinical data to support any expanded use of Antenatal Corticosteroids (ACS). A basic problem is that agents used for ACS have never been evaluated to minimize fetal exposures. Based on the premise that all drug exposure to the fetus should be minimized and only used when necessary, ACS is a potent developmental modulator that has never been evaluated to minimize the dose and durat...
Source: Seminars in Fetal and Neonatal Medicine - March 18, 2021 Category: Perinatology & Neonatology Authors: Alan H. Jobe, Augusto F. Schmidt Source Type: research

Introduction/Preface Part II
Few areas of medicine have had as much success as newborn care, one of the younger pediatric subspecialties. The term “neonatology” was only introduced in the 1960`s when the majority of preterm infants died soon after birth, mostly from respiratory failure. Today more than 75% of very preterm infants will survive to discharge, including those born at the very limits of viability. These astounding achievements would not have been possible without ground-breaking basic and translational research and thoughtful but cautious implementation of discovery into clinical practice. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - March 18, 2021 Category: Perinatology & Neonatology Authors: Ju Lee Oei, Richard J. Martin Source Type: research

The Neonatal Liver: Normal Development and Response to Injury and Disease
The liver emerges from the ventral foregut endoderm around 3 weeks in human and 1 week in mice after fertilization. The fetal liver works as a hematopoietic organ and then develops functions required for performing various metabolic reactions in late fetal and neonatal periods. In parallel with functional differentiation, the liver establishes three dimensional tissue structures. In particular, establishment of the bile excretion system consisting of bile canaliculi of hepatocytes and bile ducts of cholangiocytes is critical to maintain healthy tissue status. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - March 12, 2021 Category: Perinatology & Neonatology Authors: Naoki Tanimizu Source Type: research

Are We Over-Treating Hypoxic Spells in Preterm Infants?
A frequent challenge in Neonatology is the high frequency of spontaneously occurring hypoxemic events, a majority of which are associated with apnea or hypoventilation. These episodes present a challenge for caregivers and families as they frequently delay discharge of preterm infants. Supplemental oxygen, respiratory support, and caffeine therapy are widely used as therapeutic approaches, but challenges remain regarding their precise indications. Future clinical practice should be directed by an evidence-based approach including automated supplemental oxygen, minimizing the use of medications for gastroesophageal reflux, ...
Source: Seminars in Fetal and Neonatal Medicine - March 8, 2021 Category: Perinatology & Neonatology Authors: Steven Conlon, Juliann M. Di Fiore, Richard J. Martin Source Type: research

Therapeutic drift in newborn care- an evaluation of common practices with little or no evidence
Few areas of medicine have had as much success as newborn care, one of the younger pediatric subspecialties. The term “neonatology” was only introduced in the 1960's when the majority of preterm infants died soon after birth, mostly from respiratory failure. Today more than 75% of very preterm infants will survive to discharge, including those born at the very limits of viability. These astounding achievements would not have been possible without ground-breaking basic and translational research and thoughtful but cautious implementation of discovery into clinical practice. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - March 3, 2021 Category: Perinatology & Neonatology Authors: Ju Lee Oei, Richard J. Martin Source Type: research

Therapeutic drift in newborn care-an evaluation of common practices with little or no evidence
Few areas of medicine have had as much success as newborn care, one of the younger pediatric subspecialties. The term “neonatology” was only introduced in the 1960`s when the majority of preterm infants died soon after birth, mostly from respiratory failure. Today more than 75% of very preterm infants will survive to discharge, including those born at the very limits of viability. These astounding achievements would not have been possible without ground-breaking basic and translational research and thoughtful but cautious implementation of discovery into clinical practice. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - March 3, 2021 Category: Perinatology & Neonatology Authors: Ju Lee Oei, Richard J. Martin Source Type: research

Broadening the scope and scale of quality improvement in neonatology
Infant, newborn. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - March 2, 2021 Category: Perinatology & Neonatology Authors: John A.F. Zupancic Tags: Editorial Source Type: research